(See also Overview and Evaluation of Hand Disorders Overview and Evaluation of Hand Disorders Common hand disorders include a variety of deformities, ganglia, infections, Kienböck disease, nerve compression syndromes, noninfectious tenosynovitis, and osteoarthritis. (See also complex... read more .)
Digital flexor tendinitis and tenosynovitis are idiopathic but are common among patients with rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily involves the joints. RA causes damage mediated by cytokines, chemokines, and metalloproteases. Characteristically... read more or diabetes mellitus Diabetes Mellitus (DM) Diabetes mellitus is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia... read more . Repetitive use of the hands (as may occur when using heavy gardening shears) may contribute. In diabetes, they often coexist with carpal tunnel syndrome Carpal Tunnel Syndrome Carpal tunnel syndrome is compression of the median nerve as it passes through the carpal tunnel in the wrist. Symptoms include pain and paresthesias in the median nerve distribution. Diagnosis... read more and occasionally with fibrosis of the palmar fascia. Pathologic changes begin with a thickening or nodule within the tendon; when located at the site of the tight first annular pulley, the thickening or nodule blocks smooth extension or flexion of the finger. The finger may lock in flexion, or “trigger,” suddenly extending with a snap.
Treatment of acute inflammation and pain includes splinting, moist heat, and anti-inflammatory doses of nonsteroidal anti-inflammatory drugs Nonopioid Analgesics Nonopioid and opioid analgesics are the main drugs used to treat pain. Antidepressants, antiseizure drugs, and other central nervous system (CNS)–active drugs may also be used for chronic or... read more (NSAIDs).
If these measures fail, injection of a corticosteroid suspension into the flexor tendon sheath, along with splinting, may provide safe, rapid relief of pain and triggering. Operative release can be done if corticosteroid therapy fails.